The detection of intrathecal antibody synthesis was compared by the calculation of antibody indices (AI) derived from ELISA techniques with the detection of virus-specific oligoclonal IgGs by an antigen-mediated capillary blot technique. Twenty-seven paired serum and cerebrospinal fluid (CSF) samples were examined from 15 immunocompetent patients with herpes simplex virus encephalitis (HSE) diagnosed by PCR on early CSF samples. These techniques were also applied to paired samples from 20 multiple sclerosis (MS) patients, 10 patients with other inflammatory neurological diseases and 10 patients with non inflammatory neurological disorders. There was a good correlation between the results obtained by AI and those obtained by immunoblotting, especially in HSE (2 discordant results out of 27). Discrepancies were more frequent (25%) in MS patients where a "polyspecific" reaction characterized by low affinity antibodies is known to occur. Some of the discrepancies could, in part, be due to serological cross-reaction with varicella zoster virus.

We report the case of an 86-year-old man with severe wound infection originating from a chronic crural ulcer of the lower limb, which under negative pressure wound therapy led to excessive tissue necrosis and perforation of the anterior tibial artery. A swab taken 10 and 7 days preoperatively was positive for Helcococcus kunzii. H. kunzii has been described as a potentially pathogenic organism. The questions whether the negative pressure wound therapy itself caused the bleeding or the negative pressure wound therapy, which generates an anaerobic atmosphere, has triggered the growth and invasion of the facultative anaerobic bacterium H. kunzii and owing to the infection the artery perforated or whether the bacteria has no influence at all remain currently unanswered. After surgical debridement the signs of infection were completely eliminated, and a free musculocutaneous flap led to rapid healing of the wound. Following which H. kunzii was no longer detectable.

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